19-100299 # Warr
Plumbing
City of Federal Way Permit #:19-100299-00-PL
Commmuty Development Dept.
33325 8th Ave S
Federal Way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax:(253)835-2609 -te
Vis,a.
Project Name: WA STATE GAMBLING 11;;;I 41.,
Project Address: 501 S 336TH ST #2.0'i Parcel Number:926480 0240
Project Description: Installation of break room sink and water heater.
Owner Applicant Contractor
ROSEN PROPERTIES CITY PLUMBING INC CITY PLUMBING INC
ROSEN PROPERTIES 11432 47TH AVE NE CITYPI.955KJ(8/8/20)
1800 12TH AVE NE SUITE 312-E MARYSVILLE WA 98271 11432 47TH AVE NE
BELLEVUE WA 98005
MARYSVILLE WA 98271
IIIIIIIIIIIIIIEIIIIIIMIIIIIIIIIIIIIIIIIIIMIIIIIIIIMIIIIIO
Sinks 1 Water Heaters 1
PERMIT EXPIRES Monday, 15 July,2019
Permit Issued on Wednesday,January 16,2019
I hereby certify that the above information is cc),ect and that the construction on the above described property
and the occupancy and the use will be in - /ordance wi . the laws, rules and regulations of the State of
Washin• • and t.- -i of Federal Way. /
Owner or agent: ,// Date: < /4l
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RECEIVED
CITY OF �� JAN 16 201A. 9 PERMIT APPLICATION
PERMIT CENTER+33325 8th Avenue South +Federal Way,WA 98003-6325
Federal Way��,,�OF FEDEF{ALWAY 253-835-2607 + FAX 253-835-2609 +perrnitcenter@cityoffederalway.com
COMMUNITY DEVELOPMENT
r-----s-..-*'"%..„„,_____)
PERMIT NUMBER , _ // A/ D / Q/ _
/ / ! t� / + TARGET DATE
SITE ADDRESSSUITE/UNIT#
Z-e( S, 35 �= "1 j 201(( 70f44.e.. 1,vy wAa
6111/
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1/6-&b r a g go _ 602 4 o
TYPE OF PERMIT ❑ BUILDING INtPLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT r
/}��b 1,' lit COAL t S S i a
eiatG twin 51nviG ' w11 f J/I7 a/4114 72,./e
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
vftw �ab n f¢-try r
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAMEHONE
Ay //b,,,,,,,,,./ SAiG - 6.-1-- (2f9/
CONTRACTOR
MAILING
/ ADDRESST' %Ul0 //G 4taic� i'q/ t,
CI STATE ZIP FAX
/ ,�Ci/fd/ti - (4A' - 9f i 7/
WA STIfrE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
/ /
NAME PRIMARY PHONE
g,),-TraC7"o 2
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAMEPRIMARY P NE
PROJECT CONTACT Ji.0t /a/lf2 N/ 360 - ik-/Air(
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
_. _-
NAMEPROJECT FINANCING 0 OWNER-FINANCED
•
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19 27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses,and attorneys'fees incurred in
the investigation and defense of such claim), wh h may be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the fiance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of i applicati•
SIGNATURE: "ifDATE
PRINT NAME:
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application